Lu R, Zhang Y, Yu Y P
Department of Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China.
Zhonghua Yi Xue Za Zhi. 2019 Aug 6;99(29):2315-2318. doi: 10.3760/cma.j.issn.0376-2491.2019.29.014.
To investigate the value of the area of levator hiatusin diagnosis of uterine prolapse. From September 2017 to December 2018, 80 patients diagnosed with uterine prolapse by Department of Gynecology, Xiangya Hospital of Central South University were selected as the case group, and 80 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal three-dimensional ultrasound. The anteroposterior and transverse diameters and the area of levator hiatus were measured at rest and during maximum Valsalva maneuver respectively. The ROC curve was drawn to determine the cut-off value of area of levator hiatus in diagnosis of uterine prolapse and to evaluate its diagnostic value. At rest and during maximum Valsalva maneuver, the anteroposterior and transverse diameters and the area of levator hiatus in study group were larger than those in control group, the difference was statistically significant (0.05). During maximum Valsalva maneuver, the above values in both groups were greater than those of the same group at rest state, but there was no significant difference between the two groups (0.05). During maximum Valsalva maneuver, the best cut-off value of area of levator hiatus for the diagnosis of uterine prolapse was 22.09 cm(2), the area under curve was 0.893. The sensitivity, specificity and accuracy were 90.0%, 95.0% and 92.5%, respectively. Transperineal three-dimensional ultrasound can evaluate the morphological changes of levator hiatus in patients with uterine prolapse, and the area of levator hiatus has high diagnostic value for uterine prolapse.
探讨提肛裂孔面积在子宫脱垂诊断中的价值。选取2017年9月至2018年12月在中南大学湘雅医院妇科诊断为子宫脱垂的80例患者作为病例组,同期选取80例正常女性作为对照组。两组所有受试者均行经会阴三维超声检查。分别于静息状态及最大Valsalva动作时测量提肛裂孔的前后径、横径及面积。绘制ROC曲线,确定提肛裂孔面积诊断子宫脱垂的截断值,并评估其诊断价值。静息状态及最大Valsalva动作时,研究组提肛裂孔的前后径、横径及面积均大于对照组,差异有统计学意义(P<0.05)。最大Valsalva动作时,两组上述各值均大于静息状态时同组的值,但两组间差异无统计学意义(P>0.05)。最大Valsalva动作时,提肛裂孔面积诊断子宫脱垂的最佳截断值为22.09cm²,曲线下面积为0.893。敏感度、特异度及准确度分别为90.0%、95.0%及92.5%。经会阴三维超声可评估子宫脱垂患者提肛裂孔的形态变化,提肛裂孔面积对子宫脱垂有较高的诊断价值。